The Best Friends Approach to Dementia Care

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The Best Friends Approach to Dementia Care

• Virginia Bell, MSW
• David Troxel, MPH

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Alois Alzheimer
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Auguste D
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• November 25, 1901, 51 years old
• Problems with every day tasks
• Jealousy, delusions
• Memory
• I have lost myself

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The other face
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Be optimistic about the future
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Each person has infinite value
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Is a person with a name
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A person with a spirit
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A person with feelings
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A person with will personality
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A person with a life story
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A person who has the present moment
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A person who can still give love and affection
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A person who can reminisce and share stories
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A person who can be compassionate concerned
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A person who enjoys verbal nonverbal
communication
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A person who can be surprisingly flexible
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A person with a sense of humor
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A person who can be productive
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A person who maintains old skills talents
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A person who responds to children pets
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A person who responds to music and the arts
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A person who remains physically fit
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A person with excellent hand/eye coordination
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A person who experiences all 5 senses
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A person who responds to the experience of new
information
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A person with intact social graces
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Person-centered Care

• ?The person with dementia wants to be treated
  just like you and me.
• ?This philosophy of care is not only positive and
  life affirming, it works!

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If youve met one person with AD, youve just
met one person with AD
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Loss ? FulfillmentIsolation Loneliness
? ConnectionSadness ? CheerfulnessConfusi
on ? OrientationWorry/Anxiety ?
ContentmentFrustration ? PeacefulnessFear
? SecurityParanoia ?
TrustAnger ? CalmEmbarrassment ?
Confidence
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Find Remaining Strengths

• ? Old skills
• ? Love of music
• ? Story-telling
• ? Helping others/teaching

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The Best Friends Model
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First Steps

• ?To know someone you must walk a mile in his or
  her shoes.
• ?Empathy is important.

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Develop Basic Competencies

• ? You do not need to be an expert but . . .
• ? A well informed caregiver does a better job.
• ? Keep up to date.

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Support Basic Rights

• Use the Alzheimers Bill of Rights as a core
  statement of values or develop your own.

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Assess Frequently

• ? Do more than the basics in this area.
• ? Look for strengths.
• ? Check the daily traffic often.
• ? Set appropriate expectations.

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Enjoy creative, adult activities
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Embrace and use the persons Life Story
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A quick way to tell if a special care unit is
really special -Do staff members know and use
Life Stories?
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The Magic of Friendship

• ?Consider your own best friends.
• ?Think of the qualities of your relationships.
• ?How can this translate into better dementia care?

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Leads to Knack

• Knack is the art of doing difficult things
  with ease!
• Clever Tricks Strategies

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The Serenity Nursing Home Johannesburg,
SAOne-on-one Best Friends Each week in the
building I find that I have one more friend and
one less resident
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Best Friends CenterLexington, KentuckyFocuses
on Creative, Life-Affirming Activities
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Toca das Horttensias, Sao Paulo, Brazil

• Knack of recasting relationships
• Youve graduated from daughter to friend.

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Support Groups around the worldFriendship keeps
families connected long after memory fades
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Staff training today

• Its about teaching the knack
• And encouraging staff to build relationships

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Where do we start?
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Who are our LTC workers

• Recent immigrants
• Single moms
• ESL
• Housing issues
• Transportation issues

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Talking with staff

• Why do you work here?

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What work can represent

• Safe Harbor
• Place for community
• Place for success
• Place where someone cares for me

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Innovative Training

• Include everyone
• Teach the right content skills over information
• Not too much in any one class
• Involve games and role playing

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Innovative Training

• Take place in an environment that facilitates
  learning
• Involve follow through and modeling
• Teach life skills
• Be culturally appropriate

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Innovative Training

• Involve clients family members
• Provide incentives for learning growing
• Be evaluated by students on a regular basis

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A fundamental principle

• We cannot treat staff badly and expect badly
  treated staff to treat residents well.

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Ways To Change Culture

• Starting a personal journey
• Creating a caring community
• Programming as much for staff as residents
• Investing in training

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Loss ? FulfillmentIsolation Loneliness
? ConnectionSadness ? CheerfulnessConfusi
on ? OrientationWorry/Anxiety ?
ContentmentFrustration ? PeacefulnessFear
? SecurityParanoia ?
TrustAnger ? CalmEmbarrassment ?
Confidence